Three-dimensional reconstruction of multi-slice spiral CT has high efficacy in differential diagnosis of cecal diverticulitis and acute appendicitis

HU Yi; ZENG Linghong; HU Rongbing; YE Yun; DI Wenting; WANG Jingzhen; LIAO Hongchun

Abstract：Objective To explore the value of multi-slice spiral CT in the differential diagnosis of cecal diverticulitis and acute appendicitis.Methods A total of 128 cases of suspected acute appendicitis admitted to the First Affiliated Hospital of Changsha Medical College,Linxiang People's Hospital and Yiyang Third People's Hospital from January 2020 to September 2023 were retrospectively analyzed.All patients underwent CT plain scan and 3D reconstruction image processing before surgery.With postoperative pathological results or discharge diagnosis as the gold standard,the clinical application value of three-dimensional reconstruction of multi-slice spiral CT in the diagnosis of cecal diverticulitis and acute appendicitis was deeply explored,and the key points of differentiation between the two were analyzed.Results Among the 128 patients,49 cases of acute appendicitis,41 cases of cecal diverticulitis,21 cases of acute appendicitis combined with cecal diverticulitis and 17 cases of normal people were confirmed by operation,pathology or discharge treatment.The accuracy of three-dimensional multi-slice CT in the diagnosis of cecal diverticulitis was 96%.The accuracy of diagnosis of acute appendicitis was 98.25%.The accuracy of diagnosis of acute appendicitis with cecal diverticulitis was 100%.CT signs:The proportion of appendicitis enlargement in patients with acute appendicitis was significantly higher than that with cecal diverticulitis,with statistical significance(P＜0.05).89.80%of appendicitis patients had periappendicular exudation but no exudation around the cecum,82.93%of cecal diverticulitis patients had periappendicular exudation but no exudation around the appendix.Conclusion Multi-slice spiral CT 3D reconstruction technique has high efficacy in the differential diagnosis of acute appendicitis and cecal diverticulitis,and can provide guidance for the selection of clinical treatment.